The effect of pneumococcal conjugate vaccines on incidence and microbiology associated with complicated acute otitis media

Laursen, Bjarke; Danstrup, Christian Sander; Hoffmann, Steen; Nørskov‐Lauritsen, Niels; Christensen, A L B; Ovesen, Therese

doi:10.1016/j.ijporl.2017.07.002

Cited by 16 publications

(21 citation statements)

References 14 publications

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“…An increase in simultaneous detection of NTHi and S. pneumoniae in the middle ear was observed in the PCV13-vaccinated children in this study compared with the PCV10vaccinated children (43% versus 12%, respectively), suggesting that the PCV10 vaccine may prevent NTHi OM in this population. Lower incidence of complex OM (children with severe or recurrent OM) has been reported in Denmark [26], Sweden [27], and Israel [28] following introduction of PCVs -adding to data reported at the 2015 ISOM meeting that demonstrated the initial impact of PCVs on vaccine serotype OM [29]. Further understanding of the mechanisms underlying the reduction in pneumococcal OM have been identified through the observation that the rate of serotype-specific progression from carriage to AOM was reduced for non-vaccine serotypes compared to vaccine serotypes [28].…”

Section: Impact Of Current Vaccines On Ommentioning

confidence: 97%

Panel 8: Vaccines and immunology

Alderson

Murphy

Pelton

et al. 2020

International Journal of Pediatric Otorhinolaryngology

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Section: Impact Of Current Vaccines On Ommentioning

confidence: 97%

Panel 8: Vaccines and immunology

Alderson

Murphy

Pelton

et al. 2020

International Journal of Pediatric Otorhinolaryngology

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“…changed the microbiology of OM (38,39). Whereas PCVs have significantly reduced the incidence of invasive pneumococcal disease and have had a measurable effect on acute OM caused by serotypes of S. pneumoniae covered by the vaccine (5,(40)(41)(42), there has also been a notable emergence of OM caused by serotypes of S. pneumoniae not covered by the vaccine and also an increase in the incidence of OM caused by pathogens other than one of the usual three predominant otopathogens (43,44). Moreover, the broad use of PCVs has also resulted in a relative increase in the prevalence of OM due to NTHi.…”

Section: Figmentioning

confidence: 99%

Immunization with a Biofilm-Disrupting Nontypeable Haemophilus influenzae Vaccine Antigen Did Not Alter the Gut Microbiome in Chinchillas, Unlike Oral Delivery of a Broad-Spectrum Antibiotic Commonly Used for Otitis Media

Bailey

Lauber

Novotny

et al. 2020

mSphere

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The use of broad-spectrum antibiotics to treat diseases, such as the highly prevalent pediatric disease otitis media (OM), contributes significantly to the worldwide emergence of multiple-antibiotic-resistant microbes, and gut dysbiosis with diarrhea is a common adverse sequela. Moreover, for many diseases, like OM, biofilms contribute significantly to chronicity and recurrence, yet biofilm-resident bacteria are characteristically highly resistant to antibiotics. The most cost-effective way to both prevent and resolve diseases like OM, as well as begin to address the problem of growing antibiotic resistance, would be via the development of novel approaches to eradicate bacterial biofilms. Toward this goal, we designed a vaccine antigen that induces the formation of antibodies that prevent biofilm formation and, thereby, experimental OM in the middle ears of chinchillas by the predominant Gram-negative pathogen responsible for this disease, nontypeable Haemophilus influenzae. These antibodies also significantly disrupt preexisting biofilms formed by diverse pathogens. Whereas preclinical data strongly support the continued development of this vaccine antigen, which targets an essential structural element of bacterial biofilms, a concern has been whether active immunization would also lead to unintended collateral damage in the form of an altered gut microbiome. To address this concern, we assessed changes in the microbiome of the chinchilla gut over time after the delivery of either amoxicillin-clavulanate, the standard of care for OM, or after immunization with our biofilm-targeted vaccine antigen either via a traditional subcutaneous route or via a novel noninvasive transcutaneous route. We show that differences in the abundance of specific taxa were found only in the stools of antibiotic-treated animals. IMPORTANCE The prevalence of chronic and recurrent diseases, combined with the overuse/abuse of antibiotics that has led to the sobering emergence of bacteria resistant to multiple antibiotics, has mandated that we develop novel approaches to better manage these diseases or, ideally, prevent them. Biofilms play a key role in the pathogenesis of chronic and recurrent bacterial diseases but are difficult, if not impossible, to eradicate with antibiotics. We developed a vaccine antigen designed to mediate biofilm disruption; however, it is also important that delivery of this vaccine does not induce collateral damage to the microbiome. The studies described here validated a vaccine approach that targets biofilms without the consequences of an altered gut microbiome. While delivery of the antibiotic most commonly given to children with ear infections did indeed alter the gut microbiome, as expected, immunization via traditional injection or by noninvasive delivery to the skin did not result in changes to the chinchilla gut microbiome.

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“…Halgrimson et al [29] observed a drop in the incidence of AM after the introduction of PSV7; however, this drop was only observed in patients below the age of 2, with the incidence rate returning to pre-vaccination baseline after this age. A reduction was observed in the percentage of AM episodes caused by S. pneumoniae with simultaneous increase in the incidence of cases caused by S. pyogenes [9]. In US-based studies, a reduction in the incidence of AM was observed only after the 13-valent vaccine had been introduced [30].…”

Section: Discussionmentioning

confidence: 96%

“…Attention has also been drawn to the influence of pneumococcal vaccinations on the incidence of AM. After introduction of these vaccinations, the incidence of AM was reduced by about 20-45% [8,9]. Halgrimson et al [29] observed a drop in the incidence of AM after the introduction of PSV7; however, this drop was only observed in patients below the age of 2, with the incidence rate returning to pre-vaccination baseline after this age.…”

Section: Discussionmentioning

confidence: 99%

Acute mastoiditis in children population

Zonenberg¹,

Hassmann‐Poznańska

Skotnicka

et al. 2019

Pol Otorhino Rev

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Aim: The aim of the study was to perform a retrospective analysis of the medical documentation of patients treated for acute mastoiditis (AM) at the Department of Pediatric Otolaryngology in Bialystok and to review the available literature on this subject so as to determine optimum AM management principles. Material and methods:A retrospective analysis of 40 patients treated for AM in 2001-2017 was performed. Patient enrollment was based on the AM diagnostic criteria established by Anthonsen et al [15]. results:The mean age of the subjects was 46 months, with 37% of children being less than 2 years old. No previous episodes of acute otitis media (AOM) had been reported in 2/3 of cases. Prior to hospital admission, antibiotics had been administered to 69% of patients. In laboratory investigations, 95% of patients presented with elevated inflammation markers (CRP, leukocytosis), with the values of these markers being higher in patients qualified for surgery. Indications for computed tomography (CT) scans included lack of improvement following 48 hours of conservative treatment or the presence of symptoms of subperiosteal abscesses. CT scans were performed in 35% of patients. Conservative treatment alone was administered to 24 patients (60%); this included myringotomy with/without ventilation tube insertion and intravenous antibiotic therapy. Ceftriaxone was the most commonly used antibiotic, being administered to 75% of patients. Mastoidectomy was required in 16 patients. The most common indication (30%) for mastoidectomy consisted in the presence of subperiosteal abscess. conclusion:In non-complicated cases of AM, there is no need for routine performance of CT scans; myringotomy with or without insertion of ventilation drains should be performed and empirical intravenous antibiotic therapy should be started.In the presence of a subperiosteal abscess, a contrast-enhanced CT scan and mastoidectomy are recommended. Deterioration of patient's condition or lack of improvement after 48 hours of conservative treatment requires a CT scan being performed and the decision on potential mastoidectomy being made on the basis of the scan. Keywords:acute mastoiditis, children, acute otitis media, treatment streszczenie: cel: Celem pracy była analiza retrospektywna dokumentacji chorych leczonych z powodu ostrego zapalenia wyrostka sutkowatego (OZWS) w Klinice Otolaryngologii Dziecięcej w Białymstoku, jak również dostępnego piśmiennictwa na ten temat, w celu określenia optymalnych zasad postępowania w OZWS. Materiał i metody:Analiza retrospektywna 40 pacjentów leczonych z powodu OZWS w latach 2001-2017. Kryteria włączenia pacjentów przyjęto za Anthonsen i wsp.[15]. wyniki: Średni wiek badanych wynosił 46 miesięcy, 37% dzieci miało mniej niż 2 lata. 2/3 przypadków nie było poprzedzonych wcześniejszymi epizodami OMA. 69% chorych otrzymywało antybiotyk przed przyjęciem do szpitala. W badaniach laboratoryjnych u 95% chorych stwierdzono podwyższone wykładniki stanu zapalnego (CRP, leukocytoza), ich wartość była wyższa wśród chorych zak...

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The effect of pneumococcal conjugate vaccines on incidence and microbiology associated with complicated acute otitis media

Cited by 16 publications

References 14 publications

Panel 8: Vaccines and immunology

Panel 8: Vaccines and immunology

Immunization with a Biofilm-Disrupting Nontypeable Haemophilus influenzae Vaccine Antigen Did Not Alter the Gut Microbiome in Chinchillas, Unlike Oral Delivery of a Broad-Spectrum Antibiotic Commonly Used for Otitis Media

Acute mastoiditis in children population

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